口服利伐沙班治疗门诊患者深静脉血栓:与历史住院患者人群的倾向评分匹配比较

IF 1.5 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE
Ilya V Schastlivtsev, Kirill V Lobastov, Emel Dubar, Athena V Matveeva, Anna V Kovalchuk, Sergey N Tsaplin, Leonid A Laberko
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引用次数: 0

摘要

背景:尽管指南呼吁在门诊治疗深静脉血栓和低风险肺栓塞患者,但现实世界的证据表明,住院治疗的高患病率导致了不必要的卫生资源利用。该研究旨在评估利伐沙班在门诊治疗与住院治疗的疗效和安全性。方法:回顾性分析门诊接受口服利伐沙班治疗的深静脉血栓患者和无肺栓塞患者,并与历史住院患者进行倾向评分匹配比较。住院患者对照组在短期初始低分子肝素治疗后口服利伐沙班治疗。从电子病历中提取的相关结果如下:复发性深静脉血栓形成和症状性肺栓塞、大出血、临床相关非大出血、小出血、非计划住院和死亡。结果:209例未住院门诊患者中,深静脉血栓复发率为3.3% (95%CI, 1.6 ~ 6.8%),临床相关非大出血率2.9% (95%CI, 1.3 ~ 6.1),轻微出血率6.2% (95%CI, 3.7 ~ 10.0%),非计划住院率1.4% (95%CI, 0.5 ~ 4.1%),死亡率1.4% (95%CI, 0.5 ~ 4.1%)。无症状性肺栓塞或大出血。与住院患者对照组相比,无统计学差异。结论:门诊使用利伐沙班治疗深静脉血栓形成对于无肺栓塞患者是一种安全有效的方法,与住院患者短期初始使用低分子肝素治疗后口服利伐沙班治疗无显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Oral rivaroxaban for the treatment of deep vein thrombosis in outpatients: a propensity score-matched comparison with a historical inpatient population.

Background: Despite the guidelines' appeal to treat patients with deep vein thrombosis and low-risk pulmonary embolism in outpatient settings, the real-world evidence shows a high prevalence of inpatient therapy leading to unwarranted health resource utilization. The study aimed to assess the efficacy and safety of rivaroxaban in outpatient settings compared to inpatient treatment.

Methods: A propensity score-matched comparison with a historical inpatient population was performed based on a retrospective analysis of patients with deep vein thrombosis and without pulmonary embolism treated as outpatients with oral rivaroxaban. Inpatient controls were treated with oral rivaroxaban following a short-term initial therapy with low-molecular-weight heparins. The relevant outcomes extracted from electronic medical records were as follows: recurrent deep vein thrombosis and symptomatic pulmonary embolism, major bleeding, clinically relevant non-major bleeding, minor bleeding, unscheduled hospitalization, and death.

Results: Among 209 outpatients who were never admitted to the hospital the deep vein thrombosis recurrence rate was 3.3% (95%CI, 1.6-6.8%), clinically relevant non-major bleeding rate 2.9% (95%CI, 1.3-6.1), minor bleeding rate 6.2% (95%CI, 3.7-10.0%), unscheduled hospitalization rate 1.4% (95%CI, 0.5- 4.1%), mortality rate 1.4% (95%CI, 0.5-4.1%). No symptomatic pulmonary embolism or major bleeding was detected. No statistically significant differences were observed when compared with inpatient controls.

Conclusions: The outpatient use of rivaroxaban for deep vein thrombosis treatment is a safe and effective approach for patients without pulmonary embolism, with no significant differences when compared to inpatient therapy with oral rivaroxaban following a short-term initial therapy with low-molecular-weight heparins.

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来源期刊
International Angiology
International Angiology 医学-外周血管病
CiteScore
2.80
自引率
28.60%
发文量
89
审稿时长
6-12 weeks
期刊介绍: International Angiology publishes scientific papers on angiology. Manuscripts may be submitted in the form of editorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work. Duties and responsibilities of all the subjects involved in the editorial process are summarized at Publication ethics. Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors (ICMJE).
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